Neonatal Seizures Accompanied by Cerebral White Matter Injury Associated with Rotavirus Infection- An Extended Study | Insight Medical Publishing

Objective: This study aimed to describe the clinical characteristics and distinctive findings of diffusion restriction in cerebral white matter on diffusion-weighted imaging (DWI) in neonates presenting with seizures associated with rotavirus infection. Methods: A retrospective review of medical records was performed with neonates admitted to our neonatal intensive care unit owing to seizures, at Haeundae Paik Hospital, between 2012 and 2016. Infants tested positive result for stool rotavirus antigens and diffusion restriction in cerebral white matter were enrolled. Results: Twenty-six full-term neonates were enrolled; their mean birth weight and gestational age were 3,259 ± 527.9 g and 38.6 ± 5 weeks, respectively. They had no history of perinatal asphyxia and were healthy before acute-on-set seizures approximately 4-6 days after birth. Approximately 80% of the infants did not have any signs of infection or gastroenteritis symptoms. DWI revealed distinctive diffusion-restricted lesions in the symmetric cerebral white matter. During follow-up, favorable neurodevelopmental outcomes were observed in 21 (80.8%) infants and the prognosis is associated with the severity of the background EEG activities and normalization of follow-up EEG (p<0.05). Conclusion: Rotavirus infection should be considered in neonates with seizures and clinicians should consider the possibility of white matter injury in these infants. Although it is difficult to draw conclusions about neurodevelopmental outcomes in neonates with white matter injury associated with rotavirus infection, the prognosis is not always benign. Therefore, close attention and follow-up for long-term neurological outcomes is required for these infants.